Serum levels of sTWEAK, PAI-1, and galectin-3 in patients with type 2 diabetes mellitus combined with periodontitis: association with gingival microcirculatory dysfunction

This study aimed to analyze serum soluble TNF-like weak inducer of apoptosis (sTWEAK), plasminogen activator inhibitor-1 (PAI-1), and galectin-3 (Gal-3) in patients with type 2 diabetes mellitus (T2DM) and periodontitis and their associations with gingival microcirculatory dysfunction. A retrospective analysis was conducted on 305 T2DM patients, who were stratified into Periodontitis and Non-periodontitis groups. Clinical data, periodontal clinical parameters, and gingival microcirculatory parameters were collected. Serum sTWEAK, PAI-1, and Gal-3 levels, their associations with periodontal clinical parameters and gingival microcirculation parameters, and their discriminatory ability (individually or in combination) for periodontitis in T2DM were assessed by ELISA, Pearson’s/Spearman’s, and ROC curve analyses, respectively. Influencing factors for periodontitis in T2DM were identified by multivariate logistic regression analyses. The periodontitis group had significantly elevated serum sTWEAK, PAI-1, and Gal-3 levels. These biomarkers were positively correlated with periodontal clinical parameters and negatively correlated with gingival blood flow (GBF) and blood current velocity (BCV). Elevated levels of sTWEAK, PAI-1, and Gal-3 were independent risk factors for periodontitis, whereas increased levels of GBF and BCV were protective factors. Areas under curves (AUCs) for discriminating between periodontitis and non-periodontitis were 0.851 for sTWEAK, 0.841 for PAI-1, and 0.854 for Gal-3, with their combination achieving a significantly higher AUC (0.909). T2DM patients with periodontitis exhibited elevated levels of serum sTWEAK, PAI-1, and Gal-3, which were associated with periodontal destruction and impaired gingival microcirculation. The combination of these biomarkers showed superior discriminatory value in comparison to individual biomarkers for periodontitis in T2DM.